Page 6 - UFSTSG Care and Travel Bundle Packages
P. 6
CAREINGTON
MAXIMUM CARE
DISCOUNT PLUS
%CTGKPIVQP JCU QYPGF CPF OCPCIGF
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PGVYQTM KU MPQYP CU VJG /CZKOWO %CTG
&KUEQWPV 2NWU 0GVYQTM
Careington Dental Plan features:
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YKVJ C HQEWU QP PGKIJDQTJQQF FGPVKUVU 6JG PGVYQTM EQODKPGU VJG QWVUVCPFKPI PGVYQTM
OCPCIGOGPV UMKNNU QH VYQ ITGCV QTICPK\CVKQPU CPF TGUWNVU KP FKUEQWPVU QH VQ DGNQY VJG VJ
RGTEGPVKNG QH 4GCUQPCDNG CPF %WUVQOCT[ EJCTIGU
/GODGTU CTG CDNG VQ VCMG CFXCPVCIG QH UCXKPIU QHHGTGF D[ NGCFGTU KP VJG FGPVCN ECTG KPFWUVT[
Sample Savings
Description * Regular Cost ** Plan Cost Savings $ Savings %
Adult Cleaning $126
Child Cleaning $89
Routine Checkup $73
Four Bitewing X-Rays $85
Composite (White) Filling Code $201
Crown (porcelain fused to noble metal) $1,424
Complete Upper Denture $2,047
Molar Root Canal $1,382
Extraction (single tooth) $240
* Regular cost is based on the national average of the 80th percentile usual and customary rates as detailed in the 2015
FairHealth Report in the Los Angeles, Orlando, Chicago and New York City metropolitan statistical areas.
** These fees represent the average of the assigned Maximum Care (DN15) fees in the Los Angeles, Orlando, Chicago and New
York City metropolitan statistical areas.
Prices subject to change.
